Individual provider Active NPI

Suresh I Persad-Maharaj, MD

  • Obstetrics & Gynecology Physician
  • Savannah, GA
National Provider Identifier
1386740249
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
17717 Issued in GA
Practice address
361 B Commercial Dr.
Savannah, GA 31406-3643
Phone
(912) 352-7936
Fax
(912) 352-0079
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X GA17717 GA
Obstetrics & Gynecology Physician 207V00000X 17717 GA Primary

Addresses

Primary practice location

361 B Commercial Dr.
Savannah, GA 31406-3643

Mailing address

361 B Commercial Dr.
Savannah, GA 31406-3643
Phone (912) 352-7936

Other identifiers 1

IdentifierTypeStateIssuer
000069231AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA17717GAMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1386740249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 B COMMERCIAL DR.",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063643",
            "telephone_number": "912-352-7936",
            "fax_number": "912-352-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 B COMMERCIAL DR.",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063643",
            "telephone_number": "912-352-7936",
            "fax_number": "912-352-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSAD-MAHARAJ",
        "first_name": "SURESH",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "GA17717",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "17717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000069231A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.